Aims
In acute heart failure (AHF), relationships between changes in B‐type natriuretic peptide (BNP) and worsening renal function (WRF) and its prognostic implications have not been fully determined. ...We investigated the relationship between WRF and a decrease in BNP with in‐hospital and 1‐year mortality in AHF.
Methods and results
The Acute Kidney Injury NGAL Evaluation of Symptomatic heart faIlure Study (AKINESIS) was a prospective, international, multicentre study of AHF patients. Severe WRF (sWRF) was a sustained increase of ≥44.2 μmol/L (0.5 mg/dL) or ≥50% in creatinine, non‐severe WRF (nsWRF) was a non‐sustained increase of ≥26.5 μmol/L (0.3 mg/dL) or ≥50% in creatinine, and WRF with clinical deterioration was nsWRF with renal replacement therapy, inotrope use, or mechanical ventilation. Decreased BNP was defined as a ≥30% reduction in the last measured BNP compared to admission BNP. Among 814 patients, the incidence of WRF was not different between patients with or without decreased BNP (nsWRF: 33% vs. 31%, P = 0.549; sWRF: 11% vs. 9%, P = 0.551; WRF with clinical deterioration: 8% vs. 10%, P = 0.425). Decreased BNP was associated with better in‐hospital and 1‐year mortality regardless of WRF, while WRF was associated with worse outcomes only in patients without decreased BNP. In multivariate Cox regression analysis, decreased BNP, sWRF, and WRF with clinical deterioration were significantly associated with 1‐year mortality.
Conclusions
Decreased BNP was associated with better in‐hospital and long‐term outcomes. WRF was only associated with adverse outcomes in patients without decreased BNP.
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bstract
In the context of a McLerran-Venugopalan (MV) model for a large nucleus, coherent scattering of a virtual photon on that nucleus is evaluated in the
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= 0 gauge, the gauge appropriate for ...the target nucleus. The evaluation of the scattering in
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= 0 gauge is very intricate compared to the usual
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= 0 gauge evaluation natural for the scattering process, but has the advantage of directly giving the scattering in terms of a partonic description of the nucleus. In the limit where a tagged forward jet puts the dipole-nucleus scattering in the saturation regime the coherent reactions are equal to the inelastic reactions. In terms of the nuclear wave function the coherent reactions come from color singlet and zero total transverse momentum quark-antiquark pairs in the wave function and in the saturation regime the nuclear wave function is a coherent state for these pairs. In the saturation region half of all quarks (or antiquarks) come from zero momentum and color charge pairs.
A new transparent artificial boundary condition for the two-dimensional (vertical) (2DV) free surface water wave propagation modelled using the meshless Radial-Basis-Function Collocation Method ...(RBFCM) as boundary-only solution is derived. The two-way artificial boundary condition (2wABC) works as pure incidence, pure radiation and as combined incidence/radiation BC. In this work the 2wABC is applied to harmonic linear water waves; its performance is tested against the analytical solution for wave propagation over horizontal sea bottom, standing and partially standing wave as well as wave interference of waves with different periods.
Aims
Kidney function changes dynamically during AHF treatment, but risk factors for and consequences of worsening renal function (WRF) at hospital admission are uncertain. We aimed to determine the ...significance of WRF at admission for acute heart failure (AHF).
Methods and results
We evaluated a subgroup of 406 patients from The Acute Kidney Injury Neutrophil gelatinase–associated lipocalin Evaluation of Symptomatic heart failure Study (AKINESIS) who had serum creatinine measurements available within 3 months before and at the time of admission. Admission WRF was primarily defined as a 0.3 mg/dL or 50% creatinine increase from preadmission. Alternative definitions evaluated were a ≥0.5 mg/dL creatinine increase, ≥25% glomerular filtration rate decrease, and an overall change in creatinine. Predictors of admission WRF were evaluated. Outcomes evaluated were length of hospitalization, a composite of adverse in‐hospital events, and the composite of death or HF readmission at 30, 90, and 365 days. Biomarkers' prognostic ability for these outcomes were evaluated in patients with admission WRF. One‐hundred six patients (26%) had admission WRF. These patients had features of more severe AHF with lower blood pressure, higher BUN, and lower serum sodium concentrations at admission. Higher BNP (odds ratio OR per doubling 1.16–1.28, 95% confidence interval CI 1.00–1.55) and lower diastolic blood pressure (OR 0.97–0.98, 95% CI 0.96–0.99) were associated with a higher odds for the three definitions of admission WRF. The primary WRF definition was not associated with a longer hospitalization, but alternative WRF definitions were (1.3 to 1.6 days longer, 95% CI 1.0–2.2). WRF across definitions was not associated with a higher odds of adverse in‐hospital events or a higher risk of death or HF readmission. In the subset of patients with WRF, biomarkers were not prognostic for any outcome.
Conclusions
Admission WRF is common in AHF patients and is associated with an increased length of hospitalization, but not adverse in‐hospital events, death, or HF readmission. Among those with admission WRF, biomarkers did not risk stratify for adverse events.
In vertebrates, activation of innate immunity is an early response to injury, implicating it in the regenerative process. However, the mechanisms by which innate signals might regulate stem cell ...functionality are unknown. Here, we demonstrate that type 2 innate immunity is required for regeneration of skeletal muscle after injury. Muscle damage results in rapid recruitment of eosinophils, which secrete IL-4 to activate the regenerative actions of muscle resident fibro/adipocyte progenitors (FAPs). In FAPs, IL-4/IL-13 signaling serves as a key switch to control their fate and functions. Activation of IL-4/IL-13 signaling promotes proliferation of FAPs to support myogenesis while inhibiting their differentiation into adipocytes. Surprisingly, type 2 cytokine signaling is also required in FAPs, but not in myeloid cells, for rapid clearance of necrotic debris, a process that is necessary for timely and complete regeneration of tissues.
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► Type 2 cytokine signaling via IL-4Rα is required for muscle regeneration ► Eosinophils secrete IL-4 and are required for regeneration of injured muscle ► Myeloid or satellite cell IL-4Rα signaling is dispensable for muscle regeneration ► IL-4Rα signaling regulates the functions of fibro/adipogenic progenitors in muscle
Muscle injury promotes recruitment of eosinophils, immune cells that provide a niche for proliferating stem cells in regenerating muscle. Secretion of IL-4 by eosinophils promotes proliferation of fibro/adipogenic progenitors (FAPs) while inhibiting their differentiation into adipocytes, facilitating the engulfment of necrotic debris by FAPs.
Entrepreneurial passion has been proposed as a central characteristic of entrepreneurs, theorized to influence a host of entrepreneurial behaviors as well as firm performance. The current study ...explores one set of pathways leading from developer passion to performance, identifying self-regulatory mode (locomotion and assessment) and grit as significant conduits of this relationship. In this study, we use multi-source survey data, with 1year lagged performance data, to empirically examine relationships between developer passion, self-regulatory mode, grit, and performance. Using path analysis modeling, we find that the relationship between developer passion and grit is mediated by both locomotion and assessment, with results indicating a positive relationship between locomotion and grit and a negative relationship between assessment and grit. Our results also reveal a positive relationship between grit and venture performance. Implications of these findings to research and practice are then discussed.
•Entrepreneurial developer passion has a positive relationship with both locomotion and assessment (regulatory mode).•Locomotion has a positive relationship with grit, while assessment has a negative relationship with grit.•Grit has a positive relationship with firm performance.•The relationship between entrepreneurial passion (developer) and grit is mediated by self-regulatory mode.
A droplet‐array (DA) sandwich chip is a miniaturized platform for cell‐based high‐throughput screening. It is based on sandwiching of a glass slide with a preprinted library and a ...superhydrophobic–superhydrophilic pattern, which consists of thousands of simultaneously formed microdroplets containing cells. The DA sandwich chip allows for one‐step cell seeding, simultaneous initiation of screening, and 1000 times less reagent consumption than a regular 96‐well plate.
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